My Recent Calcium CT Scan

[Trooper]

I took a Calcium CT Scan test in order to know if I had any hidden calcium buildup or other warnings. I self-paid for the test as my insurance (Medicare) doesn't cover it.

My score was 164, results went to my doctor who wants to put me on a statin. I'm otherwise very healthy, exercise daily - either weigh training, cycling, hiking, tennis.

I really don't want to be taking statins if I don't need to. My Total Cholesterol is 208 as of last June, which is a little on the high side, but not bad. Can I control this through diet and not take the statin?

 

[joesxm3]

Dr. Ford Brewer has a Prevmed channel on youtube. You may want to watch some of his videos.

There is also a book called Unholy Trinity that you may want to read.

Brewer argues that inflammation and metabolic syndrome are more important than cholesterol in preventing actual heart attacks and that the amount of soft or liquid plaque is the real risk while calcified plaque is stable.

 

[FlaGator]

Other than curiosity, are there any risk factors that prompted this test- family history, high cholesterol, BP or resting HR? What did the doc think might be found from this test that that would improve your daily life or longevity? Given your high activity level, did he have any alternatives to the drug?

My philosophy is to not take *anything* beyond supplements of my choosing unless necessary. I've hit the mid-60's and have a daily pill tray - containing a multi-vite, probiotic, calcium supplement (reduces leg cramps after cycling), ibuprofen and melatonin. Probably healthier than I should be, and glad for it.
Maybe not a good reference point for you. A reference point, anyway.

Here's another - the guy who does my yard care is 81. Spent decades as a traveling musician/entertainer before settling down. Both his parents passed before reaching 70. Told me a few days ago, that if he knew he was going to live this long and still be active, he would have gone full throttle

 

[Trooper]

Other than curiosity, are there any risk factors that prompted this test- family history, high cholesterol, BP or resting HR? What did the doc think might be found from this test that that would improve your daily life or longevity? Given your high activity level, did he have any alternatives to the drug?

No other reason to take the test other than DW and I had heard that it had some predictive value for heart disease. I have absolutely no symptoms. I am considering telling my doctor that I would like to wait before taking the statin, to possibly get my cholesterol down through dietary changes first.

 

[oldtrig]

I took a Calcium CT Scan test in order to know if I had any hidden calcium buildup or other warnings. I self-paid for the test as my insurance (Medicare) doesn't cover it.

My score was 164, results went to my doctor who wants to put me on a statin. I'm otherwise very healthy, exercise daily - either weigh training, cycling, hiking, tennis.


I really don't want to be taking statins if I don't need to. My Total Cholesterol is 208 as of last June, which is a little on the high side, but not bad. Can I control this through diet and not take the statin?

I am almost 77 and here is my story on this.



My Calcium CT Scan test was 261 three years ago. They never ordered any more tests other than anechocardiogram back then. I was told It was a good chance I would have a heart attack in 3 to 5 years. Its been 3 years so I decided to follow up. I was told to come back in 6 months back then but never followed up.

Been doing tests they ordered in the last month. I had the stress test they say I failed and was told I needed a Heart Cath so I did it yesterday. They said my echocardiogram showed ok.

I had one artery at 50 % and the rest was good. Not enough for stents I was told.



The nurse told me that the doc would probably call in meds to help lower cholesterol but he never called them in. They tested it three weeks ago and it was only 130. HDL was 59. I go back next Friday so maybe I will know more.



It has never been over 140 so I probably won't take the meds.
I am not overweight and walk everyday plus I eat good. I went through all this and nothing really that can be done except take the cholesterol which I refuse to do. I take a 81 mg aspirin everyday.

I never had any issues with chest pain or shortness of breath. Just noticed a skip three years ago which still shows up once in a while.

Not sure these Calcium CT Scan tests mean much. Good luck on yours.

 

[JBTX]

I took a Calcium CT Scan test in order to know if I had any hidden calcium buildup or other warnings. I self-paid for the test as my insurance (Medicare) doesn't cover it.

My score was 164, results went to my doctor who wants to put me on a statin. I'm otherwise very healthy, exercise daily - either weigh training, cycling, hiking, tennis.

I really don't want to be taking statins if I don't need to. My Total Cholesterol is 208 as of last June, which is a little on the high side, but not bad. Can I control this through diet and not take the statin?

A couple of years ago I did a scan and got a result close to yours. I decided to lose about 30 pounds, get more exercise, and started taking a statin. I was once hesitant to take statins but given the score I decided to do it. My LDL got as high as 180, I got it down quickly to 120 with no meds. Then 6 months of low dose statin and weight loss LDL got down to 70.

Given my hesitancy on the statin, I started out at a half dose of rosuvastatin, or 5 mg. Looking at studies that tended to get you about 80% of the reduction that the standard starting dose of 10mg, and would lead to 30-40% LDL reduction. This was consistent with my results. In studies there are almost no side effects with such a low dose. Six months later I decided to go up to the prescribed 10mg dose.

I’ve also taken a host of supplements with mixed research on cardiovascular disease. My last bloodwork I didn’t see any real benefit. I may eventually give up some of them.

At some point in the future I may do another scan even though it usually isn’t recommended.

 

[Jerry1]

I view taking medication as a last resort. Unless something is critical, it’s always worth trying lifestyle changes (mostly diet) first.

 

[Aerides]

It's my understanding that all you can do is stop making it worse, there is no diet/exercise change that is going to improve your score. Once the calcium is there, it's not going anywhere (barring a few outliers, very young people, etc.).

I don't want to take a statin either, but if my cardiologist painted a convincing case, I'd consider it. No single factor is a reason, but a combination might be.

 

[Exchme]

The calcium score is an indicator that you have had plaque for a long time. While it's possible to have so much build up that you have poor blood flow, just having a good echocardiogram doesn't mean you have no problem. Plaque can break off and suddenly clog arteries, giving you a heart attack. The calcium itself is not the risk, in fact it helps stabilize the plaque at that spot, but in order to have an elevated score, you have enough plaque to be a serious risk factor.

I had a similar score and the write-up they gave me showed the statistics are very strong that people are better off with a statin than without. So I now take rosuvastatin, which costs just a few $ every 90 days and my cardiologist also told me to take a CoQ10 each day to help offset any side effects. If you do have side effects from the one your doctor prescribes, your doctor can switch you to other ones. Don't let the Luddites keep you from taking a medicine that has benefited millions of folks.

 

[oldtrig]

I go to the VA once a year because they check my A1C. I never been diagnosed as a diabetic. My doctor here won't test my A1C because he said insurance wouldn't pay for that test. It was 5.8 last June at the VA. Its never been over 6. I'm in group one at the VA so it don't cost me anything plus they send me my meds for free. I still keep my UHC/AARP plan F insurance and don't plan on ever canceling it. I also got plan D but using a backup is always nice.

I check my blood sugar fasting ever so often to make sure what I am doing is working. When I did the heart cath Wednesday it was 92. I watch carbs and try and get up and go back to doing something soon after I eat.

 

[anethum]

I took a Calcium CT Scan test in order to know if I had any hidden calcium buildup or other warnings. I self-paid for the test as my insurance (Medicare) doesn't cover it.
<snip>

My cardiologist ordered my Calcium CT Scan last year, and Medicare + Medigap paid for it.

 

[oldtrig]

My cardiologist ordered my Calcium CT Scan last year, and Medicare + Medigap paid for it.

Mine would have been paid for also three years ago but I had to drive a 120 mile round trip to another hospital . I just paid the $135 and drove one mile to my my local hospital.

I won't have another and probably won't have anymore heart caths . I have known for over 20 years I have metabolic syndrome . I took measures back then to do something about that but the damage was already done. My blood pressure is controlled.

Here is my results from the Heart Cath I just had. I wish it would have been better but I am almost 77 and can't go back in time and change things.



Impression:
Normal hemodynamics
Normal left ventriculography
Atherosclerotic coronary artery disease in all 3 major systems without significant stenosis

 

[thod]

My experience with statins was pretty bad. In 2018, I was having fainting spells, in the process of figuring those out many tests were conducted, I had a Calcium score of 181 (most of it in one artery.) Dr prescribed a statin. That caused a lot of issues with me.

Most of my issues were mental (memory, concentration, irritability). Your brain needs Cholesterol to function. We tried a few types, none seemed to have no side-effects. So I just quit (and informed the Doctor that I did.) 5 years later all is fine. I had another doctor prescribe Lovastatin for something else. That lasted about 3 months and I had to quit it also.

I am in very good shape, I run and bike a lot. I track my running miles, I will pass 5000 miles in a few weeks.

FYI: The fainting was caused by Vasovagal syncope. (Basically, your brain stops telling your heart to beat every now and then.) A pacemaker resolved the problem.

 

[bloom2708]

140 is plaque forming, so 208 is more than a bit high.

The best option is to switch to a whole food, plant based lifestyle. 90 or 95% will give you most of the benefit.

https://nutritionstudies.org/whole-food-plant-based-diet-guide/

Your cholesterol will drop to the 130s in 2-3 months.

Just one option to consider. Doing the same thing is the easiest. A statin is also pretty easy. Then you can keep doing the same thing with some side effects.

 

[sturge]

Following this...64, very active and in good shape, not overweight. Bike, ski, hike, regularly and diet is good although I realize there are always things that can be done to improve. No meds required ever.

Just had annual checkup with a new Doc...My cholesterol has always been right around 200 with HDL always good and LDL in elevated range (120-130ish). All other results deep in 'green'. Doctor prescribed Atorvastatin Calcium (20mg) but I'm hesitant to pull the trigger and currently researching. Have learned about side effects, that lower dosages (5-10mg) may provide 80% of value and reduce side effects, other tests I can consider (like Calcium CT), dietary things to try, etc.

Considering a followup Doc visit to discuss options to his 20mg script.

 

[Hoosierman]

my experience

I’m not a doctor, but I have been on a statin for seven years. My calcium score is 50. As others have said the fact you have calcium score of 164 means you have a significant plaque already because calcium only builds up after the soft plaque has been there for sometime. The cheapest and simplest thing you can do now is to take a statin. Some people have side effects, but if it’s well tolerated studies show that you can have a significant impact on morbidity and mortality. In fact, the lower you can get your LDL the better. It’s recommended for your LDL to be below 7D and if you can get it even lower, the most recent study shows that there are no negative consequences and the lower the more benefit. It sounds like you’re doing everything else possible but adding a statin, and reducing your LDL to below 70 would be a tremendous benefit.

 

[Trooper]

Following this...64, very active and in good shape, not overweight. Bike, ski, hike, regularly and diet is good although I realize there are always things that can be done to improve. No meds required ever.

Just had annual checkup with a new Doc...My cholesterol has always been right around 200 with HDL always good and LDL in elevated range (120-130ish). All other results deep in 'green'. Doctor prescribed Atorvastatin Calcium (20mg) but I'm hesitant to pull the trigger and currently researching. Have learned about side effects, that lower dosages (5-10mg) may provide 80% of value and reduce side effects, other tests I can consider (like Calcium CT), dietary things to try, etc.

Considering a followup Doc visit to discuss options to his 20mg script.

I just turned 66 and my lipid numbers from last June were HDL 78 , LDL 112 and triglycerides of 106. So in my case it's LDL that's out of range. To establish a baseline I am going to get another panel using requestatest.com, see if my doctor will be OK with 5 mg of Crestor vs 10mg (to minimize side effects), and research lifestyle changes to get the LDL down. I don't smoke and drink only socially.

 

[joesxm3]

I just turned 66 and my lipid numbers from last June were HDL 78 , LDL 112 and triglycerides of 106. So in my case it's LDL that's out of range. To establish a baseline I am going to get another panel using requestatest.com, see if my doctor will be OK with 5 mg of Crestor vs 10mg (to minimize side effects), and research lifestyle changes to get the LDL down. I don't smoke and drink only socially.

Your HDL to LDL ratio and TG to HDL ratio are very good.

Dr. Brewer says 5mg of Creator helps to reduce plaque but with your ratios I don't think he would recommend it to lower LDL.

 

[JBTX]

I just turned 66 and my lipid numbers from last June were HDL 78 , LDL 112 and triglycerides of 106. So in my case it's LDL that's out of range. To establish a baseline I am going to get another panel using requestatest.com, see if my doctor will be OK with 5 mg of Crestor vs 10mg (to minimize side effects), and research lifestyle changes to get the LDL down. I don't smoke and drink only socially.

I would not fear statins. I used to be hesitant but once I got a CCS score of 158 at 60 years old I figured the risks of plaque build up far exceed the theoretical and infrequent risks of statins. Also they found a decent portion of people experiencing side effects with statins is probably mental, because the control group not getting statin but thinking they were getting statin reported more side effects too (Nocebo effect)

Having said that I started with 5mg crestor - I just split the 10mg pills in half. I just did it. Dr didn’t tell me to do that. HDL went from 120 to 70, but I also lost some weight too. I eventually changed to 10mg but my LDL is still about the same.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958143/

https://pubmed.ncbi.nlm.nih.gov/22256801/

 

[Richard4444]

My cardiologist ordered a Calcium test and it was 5 two years ago - no statin indicated so I'll assume that is one thing I have to be less concerned about. Too many metrics... something's gotta wear out.
Rich

 

[JBTX]

I’m not a doctor, but I have been on a statin for seven years. My calcium score is 50. As others have said the fact you have calcium score of 164 means you have a significant plaque already because calcium only builds up after the soft plaque has been there for sometime. The cheapest and simplest thing you can do now is to take a statin. Some people have side effects, but if it’s well tolerated studies show that you can have a significant impact on morbidity and mortality. In fact, the lower you can get your LDL the better. It’s recommended for your LDL to be below 7D and if you can get it even lower, the most recent study shows that there are no negative consequences and the lower the more benefit. It sounds like you’re doing everything else possible but adding a statin, and reducing your LDL to below 70 would be a tremendous benefit.

In Europe the recommendation for LDL for those with heart disease is 55, lower than the US 70.

https://www.sciencedirect.com/scien...As a core focus of,in patients with very high

LDL for Hunter gatherers, is humans in natural settings, tends to be 50-70

https://www.sciencedirect.com/scien...poprotein,whom do not develop atherosclerosis).

 

[JBTX]

My cardiologist ordered a Calcium test and it was 5 two years ago - no statin indicated so I'll assume that is one thing I have to be less concerned about. Too many metrics... something's gotta wear out.
Rich

Whether 5 is good or not is age dependent. 5 at 60 years old is pretty good. 5 at 30 years old could be cause for concern.

For many healthy people it is zero.

 

[JBTX]

It's my understanding that all you can do is stop making it worse, there is no diet/exercise change that is going to improve your score. Once the calcium is there, it's not going anywhere (barring a few outliers, very young people, etc.).

I don't want to take a statin either, but if my cardiologist painted a convincing case, I'd consider it. No single factor is a reason, but a combination might be.

As a general rule, you can’t lower your Ccs score, but there are examples where it was lowered

https://www.researchgate.net/public...riatric_Surgery_in_People_with_Severe_Obesity

In the above study many of those with bariatric surgery experienced lower ccs scores after a number of years. They experienced significant weight loss. Whether it was weight loss or something else due to the surgery isn’t clear.

Also, they have found that people who have died of famine have no placque buildup.

Here is the story of one guy on the internet that lowered his score, FWIW

https://www.dietdoctor.com/gregs-do...rsed-his-coronary-calcium-score-by-40-on-keto

 

[dixonge]

My brother is 6' 3" and 57 yrs old. He has been overweight for many years. He is somewhere in the high 200's on the scale. All the excess weight is in his gut, mainly facing forward, and in his neck/head.

He recently got a calcium test.

IT WAS ZERO. Both the lab and his doctor confirmed, and asked him if he knew how rare that was.

Me, I was happy because I've always considered that I would outlive my baby brother. So maybe not?

He still needs to lose a lot of weight tho...

 

[RetiredHappy]

My cholesterol had been about 200 to 240 for many years, with LDL ranging from 130 to 150. Finally in 2017, I went on 10mg Atorvastatin. My total cholesterol went down to 150 and LDL to about 50 when I retested 6 months later. My cholesterol level has stayed at this low level since. Last year in April, my doctor asked if I wanted to have a CAC scan and I said absolutely. It came back as ZERO. I am 61 yo. I am not going to get off statin simply because of ZERO score. I don't have side effects from statin and it does a good job in keeping my cholesterol low.

My good friends had a CAC scan. Wife's was ZERO and his was 1000. His doctor immediately checked him into the hospital for an angioplasty. He had almost complete blockage on one artery and got a stent. His doctor said that he was surprised that my friend didn't already have a heart attack. Basically, the CAC scan detected his blockage before he had an imminent heart attack.

CAC score of 0 is really not that rare.